HomeMy WebLinkAboutSwan Lake Club_13000190112000 _ 18313_Shoreland Permits_OTTER TAIL COUNT
Land & Resource Management
Phone (218) 998-8095
PERMIT TYPE Lot Alteration Permit PERMIT NUMBER 8714
PROPERTY OWNER Swan Lake Club Inc
LAKE INFORMATION Swan
DNR ID(S)781
LOCATION
Parcel(s): 13000190112000
Township Name: Dane Prairie Township
Property Address(es): 18313 INTERLAKEN LN
Section/Township/Range: Sect-19 Twp-132 Range-042
Legal; 29.64 AC PT G.L. 3 (REC BK 203 PG 486)EX TRS
WORK AUTHORIZED
Fill approximately 4300sqft of low area with an average depth of 1.5' using pit run material. Top dress
filled area with black dirt. Extend existing drainage pipe at the same elevation to maintain previously
approved outlet. Repair old building site after Demo of existing dwelling. Install proper erosion control
measures between lake and project area prior to starting work.
Kyle Westergard 11/19/2019 11:32 AM
f8e6c2218d3ac371 b2ffcb195b17e8dc
f6ec07c58cf56696bfbfe888e41a50dd 11/19/2019 11/19/2020
Land and Resource Management Official/Date ISSUE DATE DATE EXPIRES
NOTE:
This permit must be placed in a conspicuous place not more than 6 feet above grade on the
premises on which work is to be done, and must be maintained there until completion of such work.
If the terms of this permit are violated, the entire permit may be revoked and the owner/contractor
may be subject to legal prosecution.
Property Owner is legally responsible for all surface water drainage which may occur.
Topographical Alteration projects shall be stabilized within 10 days of the completion unless
otherwise stated.
Timelines as set forth in Section IV.3.D of the Shoreland Management Ordinance shall be adhered
to.
Notify Land & Resource Management when job is ready for inspection (218) 998-8095.
11/19/2019https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=3&app=8682
https://onegov.co.ottertail.imi.us/view.php?login&id=8682Land & Resource Permit Applications
Land & Resource Management
Government Services Center
540 Fir Avenue West
Feiigus Falls MN 56537
Phone: 218-998-8095OTTER TflII0 o a ft T V - a I e a 11 o T «
Site Permit Appiications Lot Alteration Permit App. # 521, UiD # 8682
Applicant Information
Applicant Information;Name:
Mark Alan Jacobs
Phone;
(218 )770 - 1739
Email Address
mjacobs ncl@hotmail.com
Mailing Address
21356 CoUwy 22
21356 CoHwy 22
Fergus Falls MN 56537
ContractorI am the:
Is this Lot Alteration Permit
Application for Multiple
Properties?
No
Contactor's License Number and Business Name
(Contractor's Business Name:north country lawns
Property Owner's Contact Information
Properly Owner
Contact Information:
Name;
Chuck MacFarlan
Phone;
(218 ) 770 -8971
Email Address
cmacfor1ane@ottertail.com
Mailing Address
union Ave
fergus foils MN 56537
Property Information
Project
Location:Primary Name/AddressLegal DescriptionProperty Attributes Property Address
Primary Address Line 1 CityCityLegal Description Legal Description NameParcel #Property Address Legal Description
FERGUS
FALLSPTG.L. 3(REC
BK 203 PG 486)
EXTRS SWAN
LAKE
CLUB
22343 SWAN LAKE RD1300019011200018313
INTERLAKEN LN
FERGUS
FALLS
29.64 AC
N
INC
Lot Area:1291118 Square Feet
Is this lot alteration
permit
part of a
site permit application?
Shoreland Information
Associated Lakes:DNRID Lake Class LR CDLake Name
Swan 781 RD 56-781
Water Frontage:100 Feet j.
Bluff:
Proposed Project
Fill low areas as described on planProject Type:FHI Project Description:
Area to be Cut/Excayated
0 FeetTotal Cubic Yards: 0 Length:Length:OFeet Width:0 Feet Average Depth:0 Feet
0 Feet0 Feet Width:Width:0 Feet Average Depth;0 Feet Total Cubic Yards: 0 Length;
0 Feet Total Cubic Yards: 0Average Depth:
11/18/2019, 1:15 PM1 of4
https://onegov.co.ottertail.mn.us/view.php?login&id=8682Land & Resource Permit Applications
Walk-Out Basement Project
0 Feet0 Feet 0 Feet Average Depth;Length;Width;
Area to be filled/Leveled
233 Please Describe
Filled/Leveled Area:
Total Cubic Yards;100 Feet Width:42 Feet Average Depth:1.5 FeetLength;area
next
to,
ROW
0 Feet0 Feet Total Cubic Yards:0 Length;Length:0 Feet Width:0 Feet Average Depth:
0 Feet Total Cubic Yards: 00 Feet A\«rage Depth;Width:
Backfill at Foundation
0 Feet Backfill Total:00 Feet Average Depth:Linear Length:0 Feet Average Width:
Total Earth Moving Request
233 Cubic YardsTotal Earthmoving Request:
Culvert and Road Authority
Culvert?
Road Authority Approval:No
Impervious Surface - Buildings
0 Square FeetDwelling Proposed:
Attached Garage Proposed: 0 Square Feet
Detached Garage Proposed: 0 Square Feet
0 Square Feet -
Water Oriented Accessory 0 Square Feet
Structure Proposed:
1209 Square Feet
0 Square Feet
576 Square Feet
0 Square Feet
0 Square Feet
Dwelling Existing;
Attached Garage Existing:
Detached Garage Existing:
Storage Shed Existing:Storage Shed Proposed:
Water Oriented Accessory
Structure Existing;
Recreational Camping Unit
Proposed:
0 Square FeetRecreational Camping Unit
Existing:
0 Square Feet
0 Square Feet'
0 Square Feet
Miscellaneous Proposed:Miscellaneous Existing: 0 Square Feet
1785 Square FeetTotal Building Existing
Impervious:
Total Building Proposed
Impervious;
0 Square Feet1785 Square Feet Total Building Proposed
Impervious:
Total Building Existing
Impervious:
Total Building Impervious Surface; 1785 Square Feet
Impervious Surface Calculation - Buildings
1785 Square FeetTotal Building Existing
Impervious:
Total Building Proposed
Impervious:
0 Square Feet
Total Building Impervious Surface; 1785 Square Feet
1291118 Square FeetLot Area:
Impervious Sur^ce Ratio:0.0014
Buildings Impervious Surface
Percentage:
0.14 %
Impervious Surface - Other
Deck(s) Existing:0 Square Feet
.0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
Parking Area(s) Proposed: 0 Square Feet
Retaining Wall(s) Proposed; 0 Square Feet
0 Square Feet
0 Square Feet
Total Other Proposed Impervious: 0 Square Feet
0 Square Feet Deck(s) Proposed:
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
Patio(s) Proposed:Patio(s) Existing:
Sidewalk(s) Proposed:Sidewalk(s) Existing:
Landing(s) Proposed:Landing(s) Existing;
Driveway(s) Existing;Driveway(s) Proposed;
Parking Area(s) Existing;
Retaining Wall(s) Existing;
Landscaping Existing; Landscaping Proposed:
Miscellaneous Existing;Miscellaneous Proposed;
Total Other Existing Impervious:
Total Other Impervious Sur^ce:0
Impervious Surface Calculation - Buildings & Other
Total Building Other Existing 1785 Square Feet
Impervious:
Total Building + Other Proposed 0 Square Feet
Impervious;
Total Building + Other Impervious 1785 Square Feet Surface:
■i;
Lot Area;1291118 Square Feet
Building Other Impervious
Surtece Ratio;
0.0014
Building Other Impervious
Surface Percentage;
0.14 %
11/18/2019, 1:15 PM-'2 of 4
)
https://onegov.co.ottertail.mn.us/view.php?login&id=8682Land & Resource Permit Applications
Shore Impact Zone Impervious
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
Parking Area(s) Proposed: 0 Square Feet
Retaining Wall(s) Proposed: 0 Square Feet
0 Square Feet
0 Square Feet
Total Proposed Impervious in the 0 Square Feet
Shore Impact Zone:
Building(s) Proposed;0 Square FeetBuilding(s) Existing:
Deck(s) Proposed:0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
Deck(s) Existing;
Patlo(s) Proposed:Patio(s) Existing;
Sidewalks(s) Proposed:Sidewalk(s) Existing:
Landing(s) Proposed;Landing(s) Existing;
Driveway(s) Proposed;Dhveway(s) Existing;
Parking Area(s) Existing:
Retaining Wall(s) Existing:
Landscaping Proposed;Landscaping Existing:
Miscellaneous Proposed:Miscellaneous Existing:
Total Existing lmper\flOus in the
Shore Impact Zone;
Total Impervious in the Shore
Impact Zone:
0 Square Feet
Documentation
File 1: ^ MacFarlane_plan.pdfPLEASE NOTE PROPOSED
PROJECT AREA MUST BE STAKED
Documentation:
Total Impeivous Sur^ce to
Determine Fee;
0 Square Feet
233 Cubic YardsTotal Earthmov^ng Request to
Detenoine Fee:
Applicant Approval
Applicant Signature: Mark Jacobs
11/16/2019
I understand that checking this box constitutes a legal signature
Date Signed;
Please check to approve;
Attention:Kyje
Impervious less than 25%Comments:
Terms
Notes.
The lot lines and project area(s) must be identified & staked onsite.
If project disturbs more than 1 acre of land, you must obtain a General Storm Water Permit from the MPCA.
Agreement
I hereby certify that the information contained herein is correct and agree to do the proposed work In accordance with the description abo\« set forth and according to
the provisions of the Ordinances of Otter Tail County, Minnesota.
I forther agree that any plans and specifications submitted herewith shall become a part of this permit application.
Once Permit is approved, I also understand that this permit is valid for twelve (12) months from the date of approval unless otherwise indicated on permit.
Invoice #6520 (11/18/20191
TotalCostQuantityCharge
Grand Total
$0.00Total
$0.00Due
Approvals
SignatureApproval
Emma Barry -11/18/2019 1:08 PM34afbflbfe9549600f4b46691f6bc2bd
0fe55137e02f92966269cfb42cbaf23a
#1 Received and Assigned
#2 Permit Review
#3 Permit Review
#4 Permit Issuance
Public Notes
Text:
File(s):;-
Internal Notes
Text:
File(s)::-■j
11/18/2019, 1:15 PM3 of 4
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11/18/2019, 1:15 PM4 of 4
GRAVEL ROAD
FENCEcn-%isr
I'2’iwGRAVEL drivewayI
' I J-i
COLLECTION AREA WILL NOT RLL
20'5” —50*1-5/5”5T5-V2”
1675--^/5”
I
3700 5Q. FT.WAT^ COLi£CTION
OARAOE;24’
Area to fill 114’5-1/4”
130’-V2”55’9-3/4”::t P1REVI0U5LY FILLED AREAI4263 50. FT.1 OARAOE \1
_iii
9920 50, FT.
IS6 sa FT.T7SS6 sa ft.59’3-V4”
DRAIN TILE TO CONTROL WATER LEVEL
4” DRAIN TILE
109’5"CHUCK HY5L0P
TOM HY5L0P
5WAN LAKE
White - Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 - Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY4
Permit No„LEGAL
DateDESCRIPTION
3kAND
LOCATION
/Ph /pLa.<'L<^QS^O-— *^U-v\u
Lake No.Sec.Lake Name Lake Classif.Range TWP NameTWP
IDENTIFICATION: Please Print All Information
Last Name First Initial Mailing Address— No. Street. City and State Tel. No.Zip No.
rrsOwner +A y
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:
(i-FtJew^ilding
( ) Alteration
RESIDENTIAL PROPOSED USE:
(v-fOne Family Dwelling
( ) Multiple Dwelling
( ) Other
NON-RESIDENTIAL PROPOSED USE:
Specify:.
Units
( )Other Size
ESTIMATED COST OF IMPROVEMEN (omit cents)
PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
(v+1/5o^ Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
( LMndividual Septic Tank, etc.
WATER SUPPLY:
( ) Public
(.J--lTTdividual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
_________( ) Central
Basement: ( iFYtS ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms
...../.-^s5T<?.
Baths .....s^.
HEATING:
( ) Electric
( ) Coal
Other:
Type of Roof:( ) No ( ) Oil( ) Gas
( ) None( ) No
( ) Unit
^ z6-€_
^ /'Ajijai- (SialU
/■S'o K <3 "CHARACTERISTICS:
Lot Area is square feet.Water frontage is
feet. (Building Line)
feet
feet.
Building set back from high water mark is
Land height above high water mark at building line is
Building set back from State highway is.......................
Side yard is
Building will be located
Building will be located
feet — from road or street is feet.
and feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soil absorption system (Cesspool, Drainfield, etc.).
feet.
/i
,=P O
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set
forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that
shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months.
plans and specifications submitted herewith
Dated.
Signature of Owner
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit:
express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon violation of said ordinances.
Shoreland Management Official
'A.Dated
1^0AY>0Permit Fee $.State Surc)iarge $.
Comments:
Form No. MKL-0771-002 ^ VtCTM WIIKla A «•.. MHIftM. PtMtU* FMXB. «tMH.158899
White - Office
Yellow — Owner
Pink — ^ssessor
Goldenrod — Inspector
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 — Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCYV
Permit No„LEGAL
Date.DESCRIPTION
AND
LOCATION
Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name
IDENTIFICATION: Please Print All Information
Last Name First Initial Mailing Address— No. Street. City and State Zip No.Tel. No.
Owner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
I ) New Building
( ) Aiteration
( ) One Family Dwelling
( ) Multipie Dwelling
Specify:,
Units
( ) Other ( ) Other Size
ESTIMATED COST OF IMPROVEMENT $(omit cents)
PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL;DIMENSIONS:
( ) Masonry
( ) Wood Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
( ) individuai Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) individuai Weii
MECHANICAL EQUIPMENT ;
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Centrai
Basement: ( ) Yes ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms Baths
HEATING:
( ) Electric ( ) Gas
( ) Coal
Other:
Type of Roof:( ) No ( ) Oil
( ) No ( ) None
{ ) Unit ,CiCHARACTERISTICS:
Lot Area is square feet.Water frontage is,
feet. (Building Line)
...............................feet
feet.I
Building set back from high water mark is...................
Land height above high water mark at buiiding line is
Building set back from State highway is........................
Side yard is....................
Building wiii be iocated
Buiiding wiil be iocated
feet — from road or street is feet.
and .......................................feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soii absorption system (Cesspooi, Drainfieid, etc.).
feet.
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set
forth and according to the provisions of the ordinances of Otter Taii County, Minnesota. I further agree that any pians and specifications submitted herewith
shaii become a part of this permit application. I aiso understand that this permit is vaiid for a period of six (6) months.
Dated.
Signature of Owner
Permission is hereby granted to the above named appiicant to perform the work described in the above statement. This permit is granted upon thePermit:
express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon vioiation of said ordinances.
Dated
Shoreiand Management Officiai
Permit Fee $.State Surcharge $.
Comments:
—6 '
Form No. MKL-0771-002 @ VI«TtR UHlCtll 4 M.. MiraM. FCMUt rM.L«. HMIN.158899
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUALIS X MINIMUM Shall Bejr Sq. Ft
Lot Area (Square feet)Sq. Ft.Sq. Ft.
/ 90Water Frontage Ft.Ft.
9Building Set Back from High Water Mark Ft.Ft.
Building Set Back from State Highway Ft.50 Ft.
Building Set Back from Street or Road 40 Ft.Ft.
Side Yard &&Ft.Ft.
/00±Rear Yard Ft.Ft.
Occupied Building to Septic Tank Ft.10 Ft.
Occupied Building to Absorption System Ft.20 Ft.
Elevation at Building Line above
High Water Mark_____________Ft.3 Ft.
c-ccro rInspector's Comments:
“7
0
-c Ox
Inspector's Signature 7
Title
Inspection
Dated 1
Agency
VICTOI LUNBICH 4 M . BRIHTCAt. fCRAUI FALL*. HIHN.
GRID PLOT PLAN SKETCHING FORMfeet/inches.Scale: Each grid equals
Application for Building Permit Dated
Application for Sewage System Permit Dated
.19.
.19
Sewage System Permit Number.Building Permit Number.
Applicant agrees that this plot plan is a part of application (s) indicated above.
-L-l.
19____Dated.3Signature
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